coull.net - so you want to be a locum

This, of course, depends on personal circumstances and preference.¬†However, if you want to be able to choose when you work and want to be paid decent rates, but still want to work full time, then you will almost certainly have to be willing to travel away from home at least part ofthe time.

Remember, if you do travel a way from home you will have more choice in where you work, so you should expect decent rates and decent accommodation.¬†This is especially true of GP locums, where accommodation can vary from a mattress on the floor of a nurses dormitory to a four star hotel ( seebelow ).¬†

How long am I willing to stay away from home at a time if I do travel?

The two key elements to residential locum work are communications ( see below ) and accommodation.¬† Communication determines how long you can be a locum before your life falls apart.¬† Accommodation on the other hand determines how long you can be a locum before you fall apart!¬†

Imagine how you would feel after four weeks¬†without a break on a camp bed with no electricity, only a coal fire to keep you warm, an outside toilet and shower and a broken down stove to cook on - then imagine how you would feel if it had been four weeks in a warm hotel with a good bed,TV, an en suite shower and bath and good food.¬† I''ve done both (although I only managed one week on the camp bed!).

If you do a lot of residential work, and you want to maintain a semblance of a normal life, then even with excellent communication and accommodation you will still need to take more time off than if you were working from home.¬† You will need this time to travel to and from locums, rest,restock/resupply and spend time with family and friends (I normally workabout 2 weeks on and one week off on average - but one week on and oneweek off is the ideal).¬† You''re rates should reflect this.
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How can I keep in touch when I am on the move?

Keeping in touch on the move includes mobile solutions for receiving mail, phone calls, email, faxes and having internet access.¬† Keeping in touch with your financial situation is also important.

Remember, if you are working away from home that you need to try and do as much of your own paperwork when you are away as possible - otherwise you will come home for a few days off and spend all of them answering final demands for bill payments etc.!
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Mail forwarding is important if you are going to be away for more than a week at a time.¬† If someone is at home they can either deal with your mail themselves or forward or fax it to you, but the solution I use is Mail Boxes Etc .¬† They will give you a post box address for your letters and sign for any parcels that arrive.¬†¬† You can pick up your post from your box 24 hoursa day and they can forward the post and parcels to you wherever you are.¬†They can also provide office solutions such as photocopying, printing,laminating and binding so you can have your own office staff for a fraction of the normal cost.¬† One other advantage is that you can give out your postal address freely without giving out your actual address.¬†I''ve even had one patient turn up at the Mail Boxes office to pay a private fee in cash (which the staff put in my mail box with an explanatory note)!

A mobile phone is, of course, mandatory for a locum.¬† It is obviously best to use a company with good coverage in the areas you are going to work.¬† A dual band (or triband if you go to the US on holiday) phone is useful as this will allow you to make emergency calls on any network.¬†I have two mobile phones - one Vodafone and one Cellnet.¬† If I don''t want ot be disturbed on holiday, I put a message on my Vodafone saying I am away and that business callers should leave a message or send me an email, but that friends and family can call my Cellnet phone number.

Email on the move is very useful and can be achieved by one of four methods.¬†

You can take a laptop or palmtop computer and connect to the internet via a landline or mobile phone ( seebelow ).¬† If you buy a mobile phone with an infrared port and built in modem you don''t need any extra cables to connect via you mobile phone.
you can send and receive email as text messages on your mobile phone (it has to be a WAP phone).¬† Vodafone offer this service ( click here for more details ).
you can use a company that will check you email and forward any messages to your mobile phone as SMS text messages (this will work with any digital mobile phone, not just WAP phones).¬† SMSpower are a US company who provide this service in the UK as well.
you can set up an internet-based email account and pick up you messages from any internet-connected computer (eg: at the practices where you are working).¬† Examples of these free email services are Hotmail and Yahoo .

Faxes - A useful thing for locum work is a fax mailbox.¬† You are given a fax number for people to send faxes to, and when you receivea fax you are notified by email or SMS text message.¬† You can then dial in to the mailbox and have the fax forwarded to any fax number (eg:the machine at the practice where you are working, or the one at the hotel you are staying in).¬† I use Call Sciences (formerly Breath) for this - they can also give you voice messaging and one-number call screening which some people may find very useful.

Internet Access - unless you want to rely on using the practice computer to go online (if they have internet access at all!), you will need a laptop computer.¬† I use an Apple iBook and airport wireless internet connection ( seebelow )

Banking - you can take care of your finances by online banking. FirstDirect offer free internet and mobile phone banking. They will send mini-statements as SMS messages to your phone, and text messages when your account reaches a certain limit or transactions over a certain amount occur.¬†

WillI want to take a partner/children/pets with me if I travel?

If you are away from home for significant periods then you probably will.¬†¬† In General Practice and senior hospital locum work it is common for locums to take their family with them if they are going to be away from home for more than a week or two.¬†

Negotiate before you go to have decent double of family accommodation provided.¬† Not everyone agrees on this, but I am of the opinion that the practice/hospital/trust should pay for all of this for you.¬† Some practices feel that doing a residential locum is a "busman''s holiday" and expect you to pay for your family if you bring them.¬† This may be true if you do two weeks a year of residential work and spend the rest of the time at home, but if the majority of your work is residential then you will end up paying thousands of pounds a year for the privilege of being away from home and dragging you partner or family around the country.

Think what you have at home that you have paid for already and that you will be missing when you are away - your satellite widescreen TV, power shower, comfy leather sofa, exercise bike etc..¬† This is why most doctors do not want to do much residential locum work, so if the accommodation does not reflect this (as far as is possible!) then your rates should.

If the practice or trust are not paying for accommodation then you will need to recoup these costs through your earnings and your rates should reflect this as well.

¬† Click here to see my accommodation requirements that I send practices

Consider how will your family get about and what will they do while you are working. This may entail taking a second car with you or renting one when you are there.¬†

Some locums take their pets with them - dogs and cats are most common,but I''ve even seen a locum with his parrot.¬† It is advisable to inform the practice/trust of this before you arrive in case there are accommodation exclusions.

What should I take with me?

What medical equipment you take with you depends on the kind of locum work involved, how long you are going for, personal preference and the transport arrangements.¬† I take much more equipment when I go by car to a remote locum to do on call than I do when going by train or plane to a clinic based locum with no on call.¬† I find using someone else's equipment is quite a hassle, so generally speaking the more personal medical equipment you can take with you the easier your locums will be.

Click here for more details of medical equipment that can be carried.

It's a good idea to carry some of your favourite medical handbooks and a good set of road maps.

There are also quite a few personal items that can make residential locum work much easier.¬† (I keep these in a large "gadget" bag that can be easily carried).¬†

These items include:
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Cordless telephone / answering machine -¬†
to take into the bathroom, garden etc.¬† You can put your mobile number on the answering machine to avoid missing calls if you are out.¬† Get a DECT mobile phone to ensure your calls cannot be overheard (about ¬£100for a decent unit).

Wireless telephone extension set - allows you to set up a phone anywhere in the house, which is handy when there is no phone socket in the bedroom.¬† The Thompson WPJ 530U unit is available in specialist electrical stores for about ¬£70).

Digital camera - to email photos to your friends and family.¬†

DVD films -¬†
theApple iBook or powerbook laptop computers play DVDs which you can order online to be delivered anywhere in the UK by post (one week rental is ¬£3.50per DVD at movietrak.com )

Wireless internet connection - allows you to go online without having to be near a phone socket.¬†The Apple Airport is available in John Lewis for about ¬£260 for the base station and ¬£70 for an airport card for your laptop

Active speakers - to plug into your laptop for DVDs or playing music CDs.¬† A pair of sony speakers with a power adapteris about ¬£30.

Extension cables - there will never be enough power sockets in your room so take along a couple¬† of multi-socket adapters.

Smoke / CO detector - peace fo mind for those who suffer from catastrophic thinking! (¬£40 for a combined unit fromHalfords)

Travel kettle and tea bags / coffee - to use in your room.

Padded mattress protector - the quality of beds in some locum residences leaves a lot to be desired - one of these will reduce the incidenceof sleep deprivation!¬† (about ¬£80 from Ikea)

Fan heater - a small fan heater unit (¬£30 from Currysetc.) will help you heat cold locum residences in the winter and cool themdown in the summer.

Portable printer - then you have a mobile office and can take care of most of your business paperwork on the move ( click here to see my mobile office solution ).¬†

Short range 2 way radios -¬†
useful for places where the mobile phones don''t work and also double up as an intercom in large residences (around ¬£120 for two rechargeable Motorola Talkabout radios from The Link etc.)

Miscellaneous -¬†
I also take a selection of cooking utensils, spices, salt, cooking oil and a small frying pan as some residences have substandard kitchens(although this is thankfully getting less of a problem than it used to be!).¬† It also saves having to buy fresh sets of condiments everyweek.

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